Orthopaedic implants, such as knee, hip or shoulder prostheses, occasionally include components that are shipped to the surgeon or other user in a pre-assembled condition. For example, a hip prosthesis may include a bipolar component that includes a metal acetabular shell pre-assembled with a plastic liner. To lessen the chances of post-implantation failure, the shell and liner must fit together snugly, with a relatively tight interface between the two components.
Pre-assembled components, as well as other orthopaedic implant components, may be sterilized prior to use to minimize the chances of infection. Orthopaedic components may be sterilized using a number of different techniques, including gas sterilization and gamma radiation.
In some circumstances, gas sterilization is a preferred technique for sterilizing orthopaedic components. Gas sterilization utilizes a gas such as ethylene oxide (ETO) or vaporized hydrogen peroxide (VHP) to incapacitate bacterial or other disease causing agents. However, gas sterilization may be ineffective in certain circumstances. For example, if during sterilization the gas is unable to contact all surfaces of the orthopaedic components, it may not effectively sterilize those components.
Typical pre-assembled orthopaedic components may not be suitable for gas sterilization. Because of the relatively tight interface between the components, the gas may not be able to penetrate between the components to sterilize all of the surfaces. Additionally, even if some of the gas penetrates between the pre-assembled components, the gas may not necessarily be able to effectively dissipate from in between the tightly fitted pre-assembled components after sterilization is complete. Trace amounts of gas may remain in the implant, potentially having deleterious effects on the health of the individual who receives the implant.
Because typical pre-assembled orthopaedic implants may not be suitable for gas sterilization, they have in the past been sterilized using the less preferable gamma irradiation technique. Gamma irradiation may cause oxidation of plastics, such as the polyethylene commonly used for the plastic liner of a pre-assembled orthopaedic component. Oxidation of the polyethylene forming the plastic liner may weaken the component, increasing the chance that the implant will fail. Gamma irradiation may also be undesirable because it may neutralize the effects of cross-linking in highly cross-linked plastic components, also potentially weakening the component.